An Assessment of the Direct and Indirect Costs of Bladder Cancer Preceding and Following a Cystectomy: A Real-World Evidence Study


Tkacz J1, Ireland A2, Norris K1, Agatep B1, Forman C1, Ellis L3, Khaki A4
1Inovalon, Bowie, MD, USA, 2Janssen Global Services, Raritan, NJ, USA, 3Janssen Scientific Affairs, LLC, Horsham, PA, USA, 4Stanford University, Stanford, CA, USA

OBJECTIVES: To estimate the direct and indirect costs of bladder cancer prior to and following cystectomy.

METHODS: This study was a retrospective analysis of de-identified bladder cancer patients appearing in the MarketScan Commercial Claims & Encounters and Health & Productivity Management databases (10/1/2015 – 12/31/20). Inclusion criteria: 1) ≥ 1 claim containing a procedure code for cystectomy and a diagnosis code for bladder cancer (date of the cystectomy = index date); 2) 18+ years of age on index; and 3) 6 months of continuous enrollment prior to (baseline) and following (follow-up) index. All-cause total healthcare costs and indirect costs associated with short-term and long-term disability (STD and LTD) employer claims were assessed during baseline and follow-up. Descriptive analyses were performed.

RESULTS: Overall, 142 patients met inclusion criteria. The mean patient age was 56±6 years, 76% were male, and 42% of patients presented a baseline Deyo-Charlson Comorbidity Index ≥ 2. During baseline, patients incurred total all-cause direct healthcare costs of $47,781 ± $44,300, which increased to $99,259 ± $77,389 during follow-up. Regarding indirect costs, 32% of patients filed ≥ 1 STD claim during baseline, equating to a mean of 134 ± 303 hours lost and $2,353± $6,445 in total payments per patient. The rate of patients filing an STD claim increased 23.4% during follow-up, and was associated with 218 ± 324 hours lost and $3,679± $7,795 in total payments. The rate of LTD claims also increased from baseline to follow-up (1.4% to 2.8%), and among patients with ≥ 1 LTD claim post-cystectomy, resulted in 574±490 hours lost, and $1,636±$1,429 in total payments.

CONCLUSIONS: Cystectomy imposes a substantial economic burden on patients and is associated with decreased work productivity in the period following surgery. Further studies should investigate the impact of bladder-sparing treatment options on clinical and economic outcomes in patients at-risk for cystectomy.

Conference/Value in Health Info

2023-05, ISPOR 2023, Boston, MA, USA

Value in Health, Volume 26, Issue 6, S2 (June 2023)




Economic Evaluation

Topic Subcategory

Work & Home Productivity - Indirect Costs


Oncology, Urinary/Kidney Disorders

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